Conventional skin hooks are used by surgeons and other health care professionals for pulling back and holding the patient's skin along an incision previously made during a surgical procedure. These skin hooks are unguarded, and their prongs or hooks are exposed at all times. The only covers provided for such conventional skin hooks are "one-use" covers, such as frangible plastic sheaths, that are torn or otherwise removed from the skin hooks before their use.
During routine surgical procedures, the operating room assistant (such as a nurse) "slaps" the unguarded skin hook into the surgeon's hand. Preferably, the surgeon should "feel" the orientation of the skin hook and automatically grip its handle without taking his (or her) eyes off of the patient or the instrumentation in the operating room. As a result, the nurse may accidentally or inadvertently be nicked by the exposed prong (or prongs) on the skin hook. Similarly, the surgeon risks being nicked when returning the skin hook to the nurse.
Being nicked by a skin hook can be extremely uncomfortable. In addition, and more importantly, it can lead to the spreading of infection and disease. Concern over this situation has become especially acute since the appearance and spreading of the HIV virus or "AIDS". There are similar concerns with the Hepatitis B virus (referred to as "HBV").
The risks associated with a nick or puncture from conventional unguarded skin hooks during an operating room procedure are greater than those associated with needle sticks; even there, however, the problem is becoming alarming. A study was made by the Needle Stick Surveillance Group of the C.D.C. (Centers for Disease Control). Out of 3,978 needle sticks from patients known to be HIV positive, 13 health care workers became infected--roughly 1 out of 300. Thus, from a single needle stick while treating an AIDS patient in an operating room or other environment, the chances are roughly 1 out of 300 that the surgeon, nurse or other individual health care provider will sero-convert and become HIV positive.
If a surgeon, nurse or assistant is nicked or stuck by a skin hook (rather than a needle stick) while conducting a surgical procedure, the risk is greater. This is simply because, first, there is more blood involved in a surgical procedure and, secondly, the surface area of the wound may be somewhat larger. In operating on an HIV positive patient, and even if the chances of becoming HIV positive from a puncture sustained from a skin hook are substantially the same as the needle sticks--roughly 1 out of 300 --if the surgeon or nurse gets stuck with a skin hook while performing just one operating room procedure on an HIV-positive patient per day for 6 days a week, 50 weeks per year, then the chances of becoming HIV positive through an inadvertent puncture from a skin hook in an operating room procedure are virtually guaranteed in just a one-year period.
This situation has become so pronounced that some leading surgeons (as well as nurses and other individual health care providers) have stopped performing surgical procedures or also have abandoned their respective practices altogether, rather than risk the chances of inadvertently contracting the deadly HIV virus from an infected patient.
While the use of protective gloves aid in reducing the chances of being nicked during a surgical procedure, the use of such gloves are by no means foolproof; and such nicks are still quite common. Even when two sets of gloves are utilized, full protection is not afforded to the health care provider, for many times the razor-sharp surgical prongs of the skin hook cut right through both sets of gloves. Also, utilizing two sets of gloves at the same time reduces the wearer's finger dexterity, thereby presenting problems with performing the intended surgical procedure and tending to reduce the effectivity thereof.
To prevent getting stuck by a skin hook, some surgeons have resorted to other instruments which are cumbersome and awkward to use (such as a large scissors). This is time consuming and inefficient.
As a result, some leading manufacturers in the field have reported declining sales of skin hooks over the past several years.